Business of Well-being

How to Increase Participation and ROI in Corporate Wellness Programs

There are some great corporate wellness programs out there. But how many employees actually participate? How much is the cost for those not involved in wellness programs?  Every employee has a potential for great production and presence. So how can we increase adherence to the great things we offer our most valuable asset who are our employees.

According to the "Principal Financial Well - Being Index" 43 percent of employees participate in corporate wellness programs.[1]  Other polls as the Wall Street Journal Online's Health Industry Edition showed that only 9 percent of employees participate in wellness programs.[2]  

This article will address four factors which need to be considered to increase participation, success and ROI in corporate wellness programs.

  1. Stages of Change
  2. Team Building
  3. Types of Programs
  4. Reward Systems

1)   The Stages of Change:

Based on the Transtheoretical Model developed by James O. Prochaska at the University of Rhode Island in 1977.[3] There are five stages of change that need to be addressed in corporate health just as with individual coaching.

Understanding these changes will help the employer realize the importance and the difficulty people may have starting even the best of wellness programs. A successful program realizes these stages, and is prepared to assist the employee and provide direction and support. Understanding the stages and the commitment to move people to action stages will drive ROI.

  • Precontemplation - This employee is not even considering a change. This can be for many reasons as denial, fear, family concerns or lack of insight. At this stage the employee may be six months to a year away from making a lifestyle change.
  • Contemplation - During this stage employees are considering change but still have excuses not to participate. These could be lack of time, expense, family responsibility and lack of resources. This is a great time for corporate programs to work through these issues and start motivating the employee. The employee is getting closer and may be under six months from making a lifestyle change.
  • Preparation - During this stage the employee realizes there is need for a change and starts making minor lifestyle changes. These could include eating lower fat foods, taking stairs and smoking less. Also at this stage they may have a friend involved in the wellness program that may help to get them motivated. May get involved in change the next day or within six months. This is the hot potato we need to engage as soon as possible.
  • Action - The employee is engaged in the wellness program and is actively working on fitness, nutrition, weight loss, smoking cessation, alcohol usage and mental health. The employee is working on individual goals. This could be both in work and out of work settings.
  • Maintenance - At this stage the employee has been participating in the program regularly for six months to a year. This is where we would like all employees to be and strive to keep them here while they continue to work on and attain individual goals. Relapse may happen after people have been in maintenance for awhile and is not uncommon. People may have to go through relapse a few times before wellness becomes a full part of lifestyle. The key is to get back to action and participation as soon as possible after relapse and keep moving.

2)    Team Building

If you are an employer; your wellness program is one of the best ways to build your team. This is an opportunity that can be used to show the employee how much you value them and their importance. Team building is a way to create positive relations that will go towards retaining employees and developing a user friendly positive workplace.

Health and wellness is an area that presents a golden opportunity for team building yet many employers do not take advantage of this opportunity. It can also be one of the most cost effective ways to promote both wellness and your company.Here are some venues where wellness can help promote team building.

  • Human Resources: Within the HR department there should be information on all of your wellness programs and upcoming events. This not only promotes you to your employees; also potential employees filling out applications will notice that you have great programs for your employees. There should be an HR person versed in the wellness programs or be able to refer them to a wellness staff or coach.
  • Employee Orientation: This is the perfect place to get employees involved and even move them through the stages of change mentioned above. You can literally sell yourself as the greatest employer since sliced bread. This is your opportunity for you to show how much you as a corporation value the health of your workers. It has to be heartfelt and real. Having a few employees who have reached their health goals speak is a powerful tool to get people involved and build the team while promoting the corporation. This is also a chance for the wellness department to get involved in promotion and setting up one to one or group meetings with the new hires.
  • Family Participation: Depending on timing it is a great idea to get families involved. Often times they may be the ones with health issues that are creating non-presence for the employee. As families and employees get older and epidemics of diabetes are widespread the employee may need information to take care of their family. The family can also promote the employees health and help them maintain their goals. Families should be included where possible to learn more about their own health and that of the employee. Again this goes towards team building as you are now showing interest in the family and creating goodwill with your employees.
  • Inter and Intra-Corporate Wellness Campaigns: Posting wellness staff in central locations to promote the program, and sign up and collect contact information of employees. Use this as an opportunity to promote wellness by games as asking health related questions and giving prizes. This will bring attention to your program and promote commitment to workers. These campaigns can also include raffles and work into bigger venues as fun runs and health fairs.

3)    Types of Programs.

There are two types of programs that may be used to increase participation which will drive ROI. These are general employee programs and individual altered programs. There is a need for both to capture increased participation. Both programs should and can have the focus of risk factor prevention. They need to be set up to address risk assessment and focus on all employees whether they are healthy, at risk or have a known disease.

General employee programs include:

  • Health Screenings - These often include blood pressure, cholesterol, blood sugar, body mass index, waist hip ratio and fitness testing as flexibility and strength testing. Notice these screenings focus on risk factor assessment as mentioned above.
  • Gym and Fitness Centers - These programs focus on Aerobic, Strength and Flexibility training and have a variety of equipment to work different areas. There may also be classes for aerobic training, Tai Chi and strength related sessions. A fitness professional in this facility should be able to program for healthy and at risk employees to increase participation. If you are referring employees to local gym settings you should make sure the staff can program for at risk and diseased populations.
  • Seminars - These also should focus on risk factor reduction as diabetes, heart disease, weight management and exercise prescription. A program can also focus on secondary risk factors as stress management and sleep disorders as well as a separate section on woman's health. The program may also want to include family friendly topics as Alzheimer's disease.

Note: General programs are excellent and provide an opportunity for wellness in the venues mentioned above. However they may prove to be a threatening environment for many. Health and fitness testing may prove embarrassing for some even though the results are confidential. People may also have issues with body types and shy away from public programs and gyms. There may be a silent majority of non participating employees needed to be moved through the stages of change by individual programs.

Individual Altered Programs:

  • Coaching Sessions: These sessions also will address risk factor reduction while helping to develop an individual fitness, nutrition or weight management programs. These can be done either one to one or in a small group session. The coach could also on a one to one basis interpret lab results brought to them from the employee and their physician. This creates a non-threatening environment that can give the employee a sense of privacy and intrinsic motivation. Again these sessions also focus on goal setting with the employees to reduce risk factors.
  • At Home Fitness Programs: These programs can be designed by one of the wellness or fitness professionals and incorporate individual goal setting with fitness testing. They can be monitored by the individual and be updated with the fitness professional as improvements occur. At home programs also give a sense of autonomy and accomplishment. Some wellness programs have the employee monitor their workouts and give rewards for compliancy. These programs work well for people who are not comfortable in public fitness centers and like to work out alone or with a partner.
  • Online Programs: There are online programs that can interpret results for body mass index, waist hip ratio, blood pressure and other risk factors that the employee can monitor on their own. These online programs also provide a private environment as an alternative to public health screenings. Seminars can also be converted to webinar style so the employee can watch in privacy at a convenient time and also be shared with family. Daily or weekly motivational emails show the employers commitment and are a constant reminder of the wellness program.

Note: Individual programs help to create a non-threatening environment that may be conducive to get the employee through the stages of change. It is a way for the employee to have anonymity and confidentiality while still getting support. They can also be done in none work hours giving added time for individual success.

However the Robert Ross corporate wellness participation study showed that a combined approach of both types of programs were preferable.[4] The study also showed that the individual altered programs rated higher than public programs for participation. A recent Harris survey showed that 68 percent of employees with high risk or known disease follow personalized action plans.[5]

4)    Reward Systems

Reward systems as wellness programs may also come in two types. These would be external and internal rewards. Again there is a need for both to help increase motivation and show recognition for participation.

  • External Rewards: These rewards give public recognition to the employee and the corporation. These types of rewards include cash, gym memberships, movie and baseball tickets, gift certificates, parking spaces and things that are visible to all employees and hopefully motivating.
  • Internal Rewards: These rewards are possibly more motivating than external rewards. They are usually simple and involve positive reinforcement. People enjoy being told they look great! If you look at the list of why people work; usually the top two answers are to be productive and then recognized at work. Praise from a manager for sticking with the program and also doing a great job for us can be more motivating and complimentary than any external reward.

    This can even be accomplished by looking through data and sending a nice email to the employee showing appreciation. And remember the best reward ever is new found health. A simple certificate of praise for their accomplishment or a verbal thank you from the boss will keep that employee happy and healthy for years to come.


All corporations are interested in ROI and bottom line. Knowing that keeping the workforce healthier will drive business. So, we know that we are getting a great ROI from those involved in personal wellness. But corporations need to concentrate on how to get everyone motivated to participate. This will not only benefit the corporation but society as a whole.


1)    Incentive Solutions Employee Wellness Programs Benefit Both Employer and Employee Cited November 13, 2011

2)    EHS Today: The Magazine for Environment, Health and Safety Leaders Only 9 percent of Employees Participate in Employee Wellness Programs Sandy Smith November 7, 2003 Cited November 13th 2011

3)    Wikipedia The Transtheoretical Model of Behavior Change Cited November 13th 2011

4)    Wellness Managers Blog Measuring the Effectiveness of Workplace Wellness Programs Posted October 7, 2010 Cited November 13, 2011

5)    Incentive Solutions Employee Wellness Programs Benefit Both Employer and Employee Cited November 13, 2011

About The Author

Rob Goldstein is an Exercise Physiologist/Health Educator that has worked in major medical centers as Columbia Presbyterian in New York, John Muir Health and Summit Medical Center in Northern California. Rob has worked as an Exercise Physiologist in Cardiac Rehabs and helped to develop one of the first Clinical Diabetes Exercise Program in the country. He is currently a Clinical Health Educator for Blue Shield of California.

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